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在新冠疫情之后,虚拟多学科团队会议会成为肌肉骨骼肿瘤护理的常态吗?——来自一家三级肉瘤中心的经验

Will virtual multidisciplinary team meetings become the norm for musculoskeletal oncology care following the COVID-19 pandemic? - experience from a tertiary sarcoma centre.

作者信息

Rajasekaran Raja Bhaskara, Whitwell Duncan, Cosker Thomas D A, Gibbons Christopher L M H, Carr Andrew

机构信息

The Oxford Bone Tumour & Soft Tissue Sarcoma Service, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, 17, Horwood Close, Headington, Windmill Road, Oxford, OX3 7LD, UK.

Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK.

出版信息

BMC Musculoskelet Disord. 2021 Jan 5;22(1):18. doi: 10.1186/s12891-020-03925-8.

Abstract

BACKGROUND

Like with all cancers, multidisciplinary team (MDT) meetings are the norm in bone and soft tissue tumour (BST) management too. Problem in attendance of specialists due to geographical location is the one of the key barriers to effective functioning of MDTs. To overcome this problem, virtual MDTs involving videoconferencing or telemedicine have been proposed, but however this has been seldom used and tested. The COVID-19 pandemic forced the implementation of virtual MDTs in the Oxford sarcoma service in order to maintain normal service provision. We conducted a survey among the participants to evaluate its efficacy.

METHODS

An online questionnaire comprising of 24 questions organised into 4 sections was circulated among all participants of the MDT after completion of 8 virtual MDTs. Opinions were sought comparing virtual MDTs to the conventional face-to-face MDTs on various aspects. A total of 36 responses were received and were evaluated.

RESULTS

72.8% were satisfied with the depth of discussion in virtual MDTs and 83.3% felt that the decision-making in diagnosis had not changed following the switch from face-to-face MDTs. About 86% reported to have all essential patient data was available to make decisions and 88.9% were satisfied with the time for discussion of patient issues over virtual platform. Three-fourths of the participants were satisfied (36.1% - highly satisfied; 38.9% - moderately satisfied) with virtual MDTs and 55.6% of them were happy to attend MDTs only by the virtual platform in the future. Regarding future, 77.8% of the participants opined that virtual MDTs would be the future of cancer care and an overwhelming majority (91.7%) felt that the present exercise would serve as a precursor to global MDTs involving specialists from abroad in the future.

CONCLUSION

Our study shows that the forced switch to virtual MDTs in sarcoma care following the unprecedented COVID-19 pandemic to be a viable and effective alternative to conventional face-to-face MDTs. With effective and efficient software in place, virtual MDTs would also facilitate in forming extended MDTs in seeking opinions on complex cases from specialists abroad and can expand cancer care globally.

摘要

背景

与所有癌症一样,多学科团队(MDT)会议在骨与软组织肿瘤(BST)的管理中也是常态。由于地理位置导致专家出席困难是多学科团队有效运作的关键障碍之一。为克服这一问题,有人提出采用涉及视频会议或远程医疗的虚拟多学科团队,但很少有人使用和测试过。2019冠状病毒病疫情迫使牛津肉瘤服务部门实施虚拟多学科团队以维持正常服务。我们在参与者中进行了一项调查以评估其效果。

方法

在完成8次虚拟多学科团队会议后,向所有多学科团队参与者发放了一份包含24个问题、分为4个部分的在线问卷。就虚拟多学科团队与传统面对面多学科团队在各个方面进行了意见征求。共收到36份回复并进行了评估。

结果

72.8%的人对虚拟多学科团队会议的讨论深度感到满意,83.3%的人认为从面对面多学科团队会议转变后诊断决策没有变化。约86%的人报告称有做出决策所需的所有重要患者数据,88.9%的人对在虚拟平台上讨论患者问题的时间感到满意。四分之三的参与者对虚拟多学科团队会议感到满意(36.1% - 非常满意;38.9% - 中度满意),其中55.6%的人愿意未来仅通过虚拟平台参加多学科团队会议。关于未来,77.8%的参与者认为虚拟多学科团队会议将是癌症护理的未来,绝大多数(91.7%)的人认为本次活动将成为未来涉及国外专家的全球多学科团队会议的先驱。

结论

我们的研究表明,在前所未有的2019冠状病毒病疫情之后,肉瘤护理中被迫转向虚拟多学科团队会议是传统面对面多学科团队会议可行且有效的替代方式。有了有效且高效的软件,虚拟多学科团队会议还将有助于组建扩展的多学科团队,以便就复杂病例征求国外专家的意见,并能在全球范围内扩大癌症护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f5/7786952/61b449e31ea9/12891_2020_3925_Fig1_HTML.jpg

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